Nicole Penso | New York, NY • PECOS Search

Nicole Penso

Psychologist

Behavioral Health & Social Service Providers

460 W 34th St, New York, NY 10001-2320

PECOS Enrollment

Based on the most recent information from CMS, provider Nicole Penso does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1568958023
Provider Type
Individual
Full Name
Penso, Nicole
Credential
ED.M, MA. MS

Gender
Female
Sole Proprietor
No
Enumeration Date
7/9/2018
Last Updated
7/9/2018

Contact Information

Practice Location

460 W 34th St, New York, NY 10001-2320

Unlisted Fax

Mailing Location

460 W 34th St, New York, NY 10001-2320

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103TS0200X Primary	Description Psychologist Behavioral Health & Social Service Providers	License Unlisted Issuer